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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 019201396
Report Date: 12/06/2024
Date Signed: 12/06/2024 03:05:23 PM

Document Has Been Signed on 12/06/2024 03:05 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND ASC, 1515 CLAY STREET, STE. 310
OAKLAND, CA 94612
FACILITY NAME:MALINDA'S CARE HOME INCFACILITY NUMBER:
019201396
ADMINISTRATOR/
DIRECTOR:		EROLIN, MARIA LINDAFACILITY TYPE:
735
ADDRESS:3176 SAN JOAQUIN WAYTELEPHONE:
(510) 415-8585
CITY:UNION CITYSTATE: CAZIP CODE:
94587
CAPACITY: 6CENSUS: 0DATE:
12/06/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Maria Linda Erolin, Administrator TIME VISIT/
INSPECTION COMPLETED:
03:20 PM
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On 12/06/2024 at 1:00 PM, Licensing Program Analysts (LPAs) P. Manalo and L. Fontanilla announced to conduct pre licensing inspection. LPAs met with Licensee/Applicant, Maria Linda Erolin and explained the purpose of the visit. The facility has an approved fire clearance for 6 ambulatory clients.

LPAs toured facility with Licensee/applicant including but not limited to 4 bedrooms which 3 bedrooms will be occupied for clients and one staff room, 1 staff lounge, 2 bathrooms, kitchen, common areas and backyard. Bedrooms and living rooms were equipped with the proper furniture. Bathrooms were equipped with grab bars and non-skid mats. Linens and hygiene supplies were observed inside a cabinet. There is sufficient lighting throughout facility. Room temperature was maintained at 63 degrees F and hot water temperature was maintained at 136.7 degrees F. First-aid kit was observed to be complete. Smoke detectors and carbon monoxide were operational. Fire extinguisher was last serviced on 01/19/2024.

The following deficiencies were observed:
  • hot water measured at 136.7 degrees Fahrenheit
  • screen door was observed ripped
  • screen windows were observed ripped

This facility is not yet licensed, and is subject to final approval by CAB. Additional requirements may still be required.

Exit interview conducted and a copy of this report was provided to Licensee/applicant.
SUPERVISORS NAME: Yvonne Flores-Larios
LICENSING EVALUATOR NAME: Patricia Manalo
LICENSING EVALUATOR SIGNATURE: DATE: 12/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/06/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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